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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Beating the Clock: Time Delays to Thrombolytic Therapy with Advanced Imaging and Impact of Optimized Workflow
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Beating the Clock: Time Delays to Thrombolytic Therapy with Advanced Imaging and Impact of Optimized Workflow

机译：精打细算：具有先进成像功能的溶栓治疗的时间延迟和优化工作流程的影响

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Background: The effectiveness of intravenous tissue plasminogen activator in the management of acute ischemic strokes diminishes significantly with time. Advanced computed tomography (CT) imaging can be helpful to identify candidates for neurointerventional procedures. We have successfully used a 320-slice Toshiba volume CT scanner since mid-2008. Other centers have forgone advanced imaging because of concerns of time delay. This study is to assess the time delay while using this scanner compared with our 64-slice scanner. Methods: Treatment times of patients scanned with advanced imaging (CT head, dynamic CT angiography, and whole brain perfusion-group A) and patients scanned in a 64-slice scanner (CT head and traditional CT angiogram-group B) were compared. Two groups of stroke patients from November-March 2009-2010 (group 1) and 2012-2013 (group 2) were audited to assess temporal improvement. Multiple timing variables were analyzed. Results: One hundred fifty-three cases from 2009/10 and 192 cases from 2012/13 were analyzed. The median door-to-needle time (DNT) for group 1A and group 2A was 57 minutes and 47 minutes, respectively. The median DNT for group 1B and group 2B was 54 minutes and 49 minutes, respectively. Decrease in the overall DNT with group A can be attributed to the "streamlining'' of the stroke code process. There was no difference in the DNT for patients who presented during working hours versus those who presented during nonworking hours. Conclusions: With adequate experience and training, advanced stroke imaging with whole brain perfusion/dynamic CT angiography can be performed with treatment times that are comparable with traditional CT scanning.
机译：背景：静脉内组织纤溶酶原激活物在治疗急性缺血性中风中的有效性随时间显着降低。先进的计算机断层扫描（CT）成像有助于确定神经介入手术的候选人。自2008年中以来，我们已经成功使用了320片东芝体积CT扫描仪。由于担心时间延迟，其他中心已经放弃了高级成像。这项研究旨在评估使用此扫描仪与64层扫描仪相比的时间延迟。方法：比较接受高级影像学检查（CT头，动态CT血管造影和全脑灌注组A）和使用64层扫描仪（CT头和传统CT血管造影B组）扫描的患者的治疗时间。审核了2009年11月至3月（第1组）和2012-2013年（第2组）的两组中风患者，以评估其时间改善情况。分析了多个时序变量。结果：分析了2009/10年的153例和2012/13年的192例。组1A和组2A的门到针时间中位数（DNT）分别为57分钟和47分钟。第1B组和第2B组的中位数DNT分别为54分钟和49分钟。 A组总体DNT的下降可归因于卒中代码过程的“简化”，在工作时间就诊的患者和非工作时间就诊的患者的DNT均无差异。在训练中，可以使用与传统CT扫描相当的治疗时间，进行全脑灌注/动态CT血管造影的高级卒中成像。

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